A system that finds out

“Anchorage doesn’t have enough of these,” Jim Gottstein said, as he led
Flashlight to the rooftop deck above his small, somewhat cluttered, law
office downtown. The rooftop, he says, is a great place to watch the
Blue Angels when they perform at Elmendorf Air Force Base. Gottstein
says he’d stress out if he were to attend the air show on the base,
because the throngs of people the show attracts.

Gottstein is the attorney who made headlines nationwide after leaking some documents he calls “the Zyprexa papers” to the New York Times.
The documents came from a civil suit against drug manufacturer Eli
Lilly. They reportedly showed Lilly officials knew their best-selling
psychiatric drug, Zyprexa, could raise blood sugar and lead to
diabetes. The drug company denied the link and sought a court
injunction against Gottstein so he wouldn’t talk about what he calls
“the Zyprexa papers” anymore.

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On the
rooftop Gottstein dons a pair of Ray-Bans and declines to have his
picture taken. Even though he’s argued three patients’ rights cases
before the Alaska Supreme Court, he doesn’t look very lawyerly. He’s
dressed in a blue tropical-print shirt, white jeans and sneakers, as if
ready for a barbeque.

Next
week Gottstein will be presenting at a conference called the Alaska
Mental Health Recovery Conference, a two-day event at the Sheraton
Anchorage hotel sponsored by Alaska Mental Health Trust and hosted by
Alaska Peer Support Consortium, a statewide network of behavioral
health organizations. He will be talking about what mental health
agencies can do to change the system, a system he has attacked in court
for prescribing drugs too often and for ignoring patients’ rights when
the state seeks to lock them up against their will.

Much of what
Gottstein knows about psychiatric care is from research, but he also
has personal experience. His legal career was interrupted in 1982 by a
spell of psychosis. He was 29 years old and was committed to Alaska
Psychiatric Institute and given an anti-psychotic called Thiordizine.
He’s written about the experience, recalling that when he was asked to
a sign voluntary commitment statement he was given a choice: sign the
paper or the state would seek involuntary commitment in court. He
signed, but it didn’t feel voluntary. Some API staff members told him
he wouldn’t likely practice law again.

That’s the sort of
attitude that motivates Gottstein to fight for change in the mental
health system. We have a system that’s too quick to prescribe drugs, he
says. We’re also too quick to write off people with mental illness as
incurable, and too quick to diagnose and drug children. “We recognize
as ‘pathologies’ things that are really just variations of normal,” he
says. “Why not just recognize them as people, you know, variations of
people.”

Gottstein does much of his work pro bono, through
a nonprofit he founded called The Law Project for Psychiatric
Rights. One current lawsuit claims Alaska’s Office of Child
Services has a system that reaches for the prescription pad too
quickly, without first looking for other ways to help children in state
custody.

Of course, those children are in state custody to begin
with because their original home was deemed too dangerous. Gottstein
acknowledges that, but says it doesn’t automatically mean the child
needs medication. “These children are legitimately upset,” Gottstein
says. “It’s really because they are bothering the adults in their lives
that they are being diagnosed.” The Law Project, he adds, has put the
OCS case as its top priority.

Next week’s conference isn’t all
about psychiatric drugs or debating over when they should be
prescribed, says conference program director Eliza Eller of Alaska Peer
Support Consortium. “The conference is not anti-medication at all,”
Eller says. “Our main focus is that recovery happens all the time and
that peer support, from people who have been through the experience,
can be tremendously inspiring. I would say that peer support is a huge
component of recovery because hope is a huge component of recovery.”

The
conference will feature Yvonne Sanders-Butler, a school principal from
Georgia who established a “sugar free zone” and recorded rising tests
scores and fewer behavioral problems as students’ health improved.
Journalist Robert Whitaker will also speak at the conference. His book Mad In America
tries to make sense of low recovery rates for mental illness in the
U.S. and lays the problem at the feet of the medical establishment—drug
companies, doctors and institutions.

Eller expects at least 200
attendees, many of them professionals in behavioral health, but also
educators and “mental health consumers”—the field’s jargon for patients
and their families.

On the rooftop, Gottstein tells
Flashlight that the degree to which children are prescribed drugs is
“an emergency” and says there’s little proof it’s even safe. Still, he
says, he isn’t suing for a completely drug-free mental health system:
“I don’t say that the drugs should never be used. What I say, and what
Bob (Whitaker) says, is that they should only be used selectively.”

What’s
needed, he says, “is a system that finds out” who needs medications.
“Because some people find that the drugs do work, and you know what?
They take them voluntarily.”

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Comments

Daniel Haszard wrote on May 7, 2009 1:30 AM:

" Lilly Zyprexa use by Children.

Zyprexa,as
well as the other atypical antipsychotics, are being prescribed for
children, even though this is an unapproved, off-label use. Eli Lilly
has been charged in allegedly pushing the drug for children in more
than one state.

A report by Dr. Cooper at Vanderbilt
University states that 2.5 million children are now taking atypical
antipsychotics. Over half are being given them for Attention Deficit
Hyperactivity Disorder. Perhaps it is statistics like these that caused
the FDA to finally require warnings on the labels of the ADHD drugs.

Daniel Haszard "

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